Part 33
But if the bone be fairly broken across (this, however, rarely happens),
it is to be set in the manner now described. When adjusted, the teeth
are to be fastened together as formerly described, for this will contribute
much toward keeping the parts at rest, especially if properly fastened,
and the ends of the thread secured with knots. But it is not easy
to describe exactly in writing the whole manipulation of the case;
but the reader must figure the thing to himself from the description
given. Then one must take a piece of Carthaginian
leather; if the
patient be a younger person, it will be sufficient to use the outer
skin, but if an adult the whole thickness of the hide will be required;
it is to be cut to the breadth of about three inches, or as much as
will be required, and having smeared the jaw with a little gum (for
thus it sticks more pleasantly), the end of the skin is to be
[p. 231] fastened
with the glue near the fractured part of the jaw, at the distance
of an inch or a little more, from the wound. This piece is to be applied
below the jaw; but the thong should have a cut in it, in the direction
of the chin, so that it may go over the sharp point of the chin. Another
piece of thong like this, or somewhat broader, is to be glued to the
upper part of the jaw, at about the same distance from the wound as
the other thong; this thong should be so cut as to encircle the ear.
The thongs should be sharp-pointed at the part where they unite, and
in gluing them, the flesh of the thong should be turned to the patient's
skin, for in this way it will be more tenacious; then we must stretch
this thong, but still more so the one at the chin, in order to prevent
the fragments of the jaw from riding over each other, and the thongs
are to be fastened at the vertex, and then a bandage is to be bound
round the forehead, and a proper apparatus is to be put over all,
to prevent the bandages from being displaced. The patient should lie
upon the sound side of the jaw, not resting upon the jaw, but upon
the head. He is to be kept on a spare diet for ten days, and then
nourished without delay. If there be no inflammation during the first
days, the jaw is consolidated in twenty days; for callus quickly forms
in this, as in all the other porous bones, provided there be no sphacelus
(
exfoliation?). But much remains to be said on the sphacelus of bones
in another place. This method of distention with glued substances
is mild, of easy application, and is useful for many dislocations
in many parts of the body. Those physicians who have not judgment
combined with their dexterity, expose themselves in fractures of the
jaws, as in other cases, for they apply a variety of bandages to a
fractured jaw-bone, sometimes properly, and sometimes improperly.
For all such bandaging of a fractured jawbone has a tendency rather
to derange the bones connected with the fracture, than to bring them
into their natural position.
